This blog post summarizes 556 pages of the latest information published on December 30th by CMS regarding the American Recovery and Reinvestment Act (ARRA) and the $44,000 in economic stimulus payments available to Physicians / Podiatrists who deploy certified Electronic Medical Record systems (EMR) or as the document refers to them as certified Electronic Health Record systems (EHR).

CMS continues to move forward in implementing the $44,000 economic stimulus payments for Physicians / Podiatrists who deploy a certified electronic medical records system as mandated in the ARRA. For those unfamiliar with the program, please read the prior blog post from March 2009. $18,000 in incentive payments will be available in year one, 2011. The government has finally set the specific requirements and guidelines for qualifying for the first year payment. DOX Podiatry is well positioned and ARRA stimulus ready to help you qualify!

Requirements summarized:

1) Deploy a certified electronic health record system. Final regulations for certification will be published by April 1 and will take effect 60 days later. Thus, the earliest a vendor can officially apply for Certification will be June 1, 2010 and vendors will have the rest of 2010 to complete the certification process to ensure their customers can qualify for stimulus payments in 2011. DOX Podiatry is stimulus ready and will complete the certification process prior to December 31, 2010 ensuring all of our customers will be able to qualify for 2011 stimulus payments.

2) Demonstrate meaningful use for a 90 day period, anytime within calendar year 2011. Example, January 1 to March 30, 2011 or October 1 to December 29, 2011, or any other 90 day contiguous period which falls completely within calendar year 2011. DOX Podiatry can help you meet all the requirements of Stage 1 which are required for you to receive your $18,000 payment in 2011. The Stage 1 meaningful use criteria focuses on:

a. Electronically capturing health information in a coded format using that information to track key clinical conditions and communicating that information for care coordination purposes (whether that information is structured or unstructured, but in structured format whenever feasible). DOX Podiatry was built from the ground up utilizing state of the art database technology (not old template based technology) which enables all information to be captured in a structured format. DOX Podiatry output is also available in Microsoft Word format for easy transmittal to organizations not capable of receiving structured information.

b. Implementing clinical decision support tools to facilitate disease and medication management. This has always been a core component of DOX Podiatry. DOX Podiatry is a diagnostic driven system, helping Physicians and staffs work through the diagnosis, treatment and planning process.

c. Reporting clinical quality measures and public health information. Requirements in this area have been significantly loosened in the latest rules publication. Coming enhancements to the DOX Podiatry system will enable Physicians to collect, tabulate, and report on quality measures.

d. See Appendix at the bottom of this post for very specific details on requirements to meet Meaningful Use criteria.

3) Use your EHR system for 80% of all patient encounters during 90 day reporting period.

4) Collecting your maximum stimulus payment of $18,000 in 2011 for the Medicare program. (This blog post does not comment on the requirements for Medicaid program.)

a. Medicare billings must be greater than $24,000 in 2011

b. Payment is on a rolling basis after you demonstrate meaningful use for 90 days

c. Employer can collect for all Physicians on staff – no limit. Each Physician must have Medicare billings in excess of $24,000 in 2011.

DOX Podiatry is ready to help you improve your practice and get your share of the economic stimulus program. Getting started is easy! DOX Podiatry employs a unique pricing model with no software to buy, no initiation fees, and a simple low per Physician monthly service fee.

Call today for your no obligation, no cost demonstration and consultation and learn how you can qualify for your $18,000 bonus in 2011 and $44,000 over five years; or email info@doxemr.com or visit www.DoxEmr.com.

Save up to 50% when you ask about our special ARRA Stimulus Ready promotion!

Appendix:

Details regarding the goals, objective, and requirements to meet “Meaningful Use” in Stage 1 for Stimulus payment qualification in 2011. DOX Podiatry will enable you to meet all of these requirements in 2011.

1) The first health outcomes policy priority specified by the HIT Policy Committee is improving quality, safety, efficiency and reducing health disparities. The HIT Policy Committee identified the following care goals to address this priority:
a. Provide access to comprehensive patient health data for patient’s healthcare team.
b. Use evidence-based order sets and computerized provider order entry (CPOE).
c. Apply clinical decision support at the point of care.
d. Generate lists of patients who need care and use them to reach out to those patients.
e. Report information for quality improvement and public reporting.

2) For Physicians, the following objectives in the Stage 1 criteria of meaningful use were designed to further the care goal of improving quality, safety, efficiency and reducing health disparities.
a. Use CPOE. We believe that the term “CPOE” requires additional clarification.
b. We propose to define CPOE as entailing the provider’s use of computer assistance to directly enter medical orders (for example, medications, consultations with other providers, laboratory services, imaging studies, and other auxiliary services) from a computer or mobile device. The order is also documented or captured in a digital, structured, and computable format for use in improving safety and organization. For Stage 1 criteria, we propose that it will not include the electronic transmittal of that order to the pharmacy, laboratory, or diagnostic imaging center.
c. Implement drug-drug, drug-allergy, drug-formulary checks.
d. Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT®.
e. We believe the term “problem list” requires additional clarification. We describe a “problem list” as a list of current and active diagnoses as well as past diagnoses relevant to the current care of the patient.
f. Generate and transmit permissible prescriptions electronically (eRx).
g. The concept of only permissible prescriptions refers to the current restrictions established by the Department of Justice on electronic prescribing for controlled substances. (The restrictions can be found at http://www.deadiversion.usdoj.gov/schedules/schedules.htm)
h. Maintain active medication list.
i. Maintain active medication allergy list.
j. Record the following demographics: preferred language, insurance type, gender, race and ethnicity, and date of birth.
k. Record and chart changes in the following vital signs: height, weight and blood pressure; calculate and display body mass index (BMI) for ages 2 and over; plot and display growth charts for children 2 – 20 years, including BMI.
l. Record smoking status for patients 13 years old or older.
m. Incorporate clinical lab-test results into EHR as structured data. Structured data are data that have specified data type and response categories within an electronic record or file.
n. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach.
o. Report ambulatory quality measures to CMS (only in paper format for Stage 1 – i.e. 2011 and potentially 2012)
p. Send reminders to patients per patient preference for preventive/follow-up care.
q. Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic test ordering, along with the ability to track compliance with those rules.
r. We do not propose to include the objective “Document a progress note for each encounter”. Documentation of progress notes is a medical-legal requirement and a component of basic EHR functionality, and is not directly related to advanced processes of care or improvements in quality, safety, or efficiency.

Call DOX Podiatry today for your no obligation, no cost demonstration and consultation and learn how you can qualify for your $18,000 bonus in 2011 and $44,000 over five years; or email info@doxemr.com or visit www.DoxEmr.com.

Save up to 50% when you ask about our special ARRA Stimulus Ready promotion!

To view the entire 556 page docment published on 12/30/2009 please click on the following link: http://www.federalregister.gov/OFRUpload/OFRData/2009-31217_PI.pdf.

January 29th-31st
New York Clinical Conference and Exhibition
New York City, NY
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February 4th-6th
Podiatry Institute Park City
Park City, UT
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February 23th-25th
ACFAS Annual Scientific Conference
Las Vegas, NV
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March 11th-14th
Midwest Podiatry Conference
Chicago, IL
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Below you will find the detailed language explaining the incentive available for Podiatrists to deploy Health Information Technology and use an EMR application prior to 2011. Podiatrists will be eligible for $44,000 in bonus dollars over the course of 5 years (see table). If Podiatrists do not deploy and use EMR prior to 2015 they will begin to be penalized via reduced payments from Medicare. Still to be determined by the task force established via the legislation is what will be the certification process for EMR technologies and how doctors will receive the bonus funds (Cash, Tax Credit, etc.) These final details will be published before the end of calendar year 2009. The key take-away is that anyone who plans to still be practicing in 2011 and beyond needs to begin deploying and using an EMR system.

Incentive payments to eligible Podiatrists:
An eligible Podiatrist will receive incentive payments as specified in the legislation, for the first five years (2011 –2015), for demonstrating a meaningful use of EHR technology and demonstrated performance during the reporting period for each payment year. If an eligible Podiatrists does not demonstrate meaningful use by 2015, his/her reimbursement payments under Medicare will begin to be reduced. No incentive payment will be made after 2016.

A meaningful user is an eligible Podiatrist that:
1) Demonstrates to the satisfaction of the Secretary that during such period the professional is using certified EHR technology in a meaningful manner, which shall include the use of electronic prescribing as determined to be appropriate by the Secretary;

2) Demonstrates to the satisfaction of the Secretary that during such period such certified EHR technology is connected in a manner that provides, in accordance with law and standards applicable to the exchange of information, for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination; and 3) Submits information for such period, in a form and manner specified by the Secretary, on such clinical quality measures and such other measures as selected by the Secretary.

Certified EHR technology means an EHR that is certified to meeting standards pursuant to this Act. To be qualified as a certified EHR technology, the certified technology must include patient demographic and clinical health information, such as medical history and problem lists, and has the capacity to provide clinical decision support to support physician order entry, to capture and query information relevant to healthcare quality, and to exchange electronic health information with, and integrate such information from other sources.  DOX Podiatry meets all of these requirements today. 

Payment schedule for an eligible Podiatrists is as follows:

If eligible Podiatrists have not become meaningful users of EHRs by 2015, they will not receive full Medicare payments beginning in 2015. The reduction in the fee schedule is as follows:
2015 – 99%;
2016 – 98%
2017 and each subsequent year – 97%

Call the experts at DOX Podiatry! We offer the leading web-based Electronic Medical Records (EMR) / Electronic Health Records (EHR)and Health Information Technology (HiTech) solutions created explicitly for Podiatry. Join the hundreds of other Podiatrists who are benefiting by saving time and making more money through the use of DOX Podiatry. Now with the added bonus that the government will reward you with $44,000 for improving your practice, making more money, and saving time!

Visit www.DoxEmr.com, Call 1-877-270-3518, or email info@DoxEmr.com to arrange for your personnel consultation and demonstration.

Check back often as new events and topics are added frequently.

January 15th-17th
SAM 2009 – Island Time in ’09
Orlando, FL
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January 23rd-25th
New York Clinical Conference and Exhibition
New York City, NY
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February 12th-14th
Annual Georgia Summit
Atlanta, GA
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March 5th-7
ACFAS Annual Scientific Conference
Washington, DC
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April 2nd-4th
Midwest Podiatry Conference
Chicago, IL
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June 25th-27th
The Western Podiatric Medical Conference
Anaheim, CA
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